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Locally injected steroids can be useful in the treatment of inflamed joints and inflammation of soft tissue. They do this by potently suppressing the inflammation and shrinking the swollen tissue particularly in the short term. They are called local because they act only in the injected area. Injecting a joint is called an `intra-articular` injection while injection close to a joint is called `peri-articular`

How long will it be before my joints feel better?

The local anaesthetic will start to reduce your pain within a few minutes of the injection.

This pain relief will last for 1-2 hours. The steroid will take longer to start working; sometimes it can be nearly 1-2 days after the injection before you start to feel better. So while you are waiting for the steroid to work you can take painkillers such as paracetamol, or cold packs.

The joint you have had injected will hopefully feel better for up to 3 months and sometimes longer , but everybody is different so it may not last this long. If you have had previous injections and they have not lasted this long then it would be advisable to have your condition re-assessed and a new treatment plan decided with your clinician.

Do I need to rest after the injection?

It is recommended to rest the joint that has been injected for 48 hours this helps the injection work better. If this is impractical then it is advisable to avoid any strenuous exercise for the following 48 hours.

A general principle is to move the joint injected as normal but do not lift or push heavy objects for a week after the injection.

How often can I have my foot injected?

We do not want to give you too many injections. The most we will give you is 2-3 in a year, into the same joint. Very occasionally we will give you more than this if there are special reasons. However, there is a small risk of frequent injections causing cartilage damage, especially in weight-bearing joints. Your clinician will be able to advise you more specifically about this risk.

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• Orthotics are created by taking a cast of the individual patient’s foot and designing a device which corrects and balances abnormalities. This device can be used in the patient’s own shoes.
• We only use the highest quality Orthotics Laboratory to produce our custom made devices, meaning the quality is superior to most available on the market and the product may last anywhere between 5 – 10 years depending on usage.

Orthotics are devices used to alter or modify foot function in order to treat biomechanical foot disorders. Orthotics are an effective method of treating foot, ankle, knee, hip and lower back pain.

They range from simple, in-shoe devices, such as insoles, to custom-made orthotics designed to meet the individual needs of each patient.

The orthotics are created by taking a cast of the individual patient’s foot and designing a device which corrects and balances abnormalities.

This is often an extremely effective method of treating foot, ankle, knee, hip and lower back pain.

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Skin and nail conditions can often be a challenging problem to deal with alone. Often, we can see photos or read online and feel we have a particular condition. This can sometimes be an effective way to manage a problem, however if you seek a professional diagnosis and advice, your Podiatrist will be able to happily listen to and discuss your concerns.

Common conditions/symptoms may include:

o   Fungal Nails

o   Corns/Callus

o   Athletes Foot

o   Verrucas

o   Thickened nails or flaking skin

o   Wounds/Sore/Blistering

o   Cellulitis

o   Rash

o   Swelling

What will the Podiatrist do for my problem?

You will first receive an Initial Consultation where we will assess, diagnose and advise on the available treatment options which will be outlined to you. A joint decision will then be made on your individual management plan, suited to your needs and tied in with the best available scientific evidence. Most treatments/procedures are billed at an additional cost (therefore please refer to our Price Charter prior to your Consultation), though simple procedures may be undertaken during the appointment at no further expense.

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We believe at OsteoGait Podiatry that a definitive solution is often the best solution.

This often involves advising patients on more invasive treatment options to conclusively treat their underlying Foot & Ankle problems. We offer a wide range of minor surgical procedures, the most common being Nail Surgery for ingrown/ingrowing or thickened toenails.

Nail surgery is performed under local anaesthetic for the treatment of painful toe nails. This means that only the affected toe is injected with anaesthetic and numbed. You will be awake throughout the surgery. You will still be able to feel your toe being moved but you will not feel any pain.

The procedure takes about 20-30 minutes and you will be able to carry out the majority of day to day activities immediately afterwards but need to discuss this further with your Podiatrist.

Once the whole of the nail or part of the nail is removed a chemical (phenol) is applied to the nail bed and should ensure that the nail does not re-grow, offering a permanent resolution to the problem.

This ensures that you do not need to routinely have a painful ingrown toe-nail cut away and you can be rid of the problem in its entirety.

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A Gait Analysis assessment involves an examination of the lower limbs, looking at their structure, alignment, strengths and weaknesses.

The examination is not focused simply upon the foot but includes the pelvis, legs and knees, assessing the relationship between them. It is important to examine the lower limbs as a whole because they are closely connected and pain in one area can be due to a weakness or structural problem in another area.

What are the benefits of a Gait Analysis assessment?

A biomechanical or Gait Analysis assessment is very beneficial if you are experiencing pain in your feet or lower limbs but no cause has been established. A biomechanical assessment is the starting point for understanding the cause of your problem, what treatment is needed or whether further investigations are necessary. The analysis allows us to write an accurate prescription for your Orthoses, otherwise it is like buying eye glasses off the shelf with no prescription.

What happens during the assessment?

You will be asked to lie on a couch while the Podiatrist examines the joint range of motion of your hips, knees and feet. Your muscle strength and weakness will also be assessed and the Podiatrist will look for any signs of leg length discrepancy. The Podiatrist examines the structure of your foot, looking at the relationship between the forefoot and rearfoot. While you stand in a relaxed stance, the alignment of your feet and relationship to the lower legs will be assessed. Our Podiatrists use high-tech Video Gait Analysis as part of a biomechanical assessment. You will be asked to walk and run on the treadmill in order to precisely record your gait and the video will be played back for you to see and the Podiatrist to examine. The Video Gait Analysis enables the Podiatrist to see whether there is any rotation in the pelvis during running, any alignment problems and excessive foot movement which is often the source of Foot & Ankle complaints.

What sort of treatment will I need after the assessment?

There are many different types of recommended treatments following a biomechanical assessment, depending upon your results. For people who have good structural foot mechanics, the Podiatrist will advise on the best footwear in order to reduce the risk of foot problems. Simple changes such as wearing trainers designed for your gait or wearing insoles/orthotics can be very effective. If the Podiatrist believes that your mechanics could be contributing to your injury or pain, insoles or custom made orthotics will be prescribed or a steroid injection recommended.

Patients are referred to a physiotherapist if they will benefit from exercises to improve muscle strength or flexibility. Referrals may also be made to an osteopath, sports doctor and rheumatologist. Patient may also be referred for imaging such as X-rays, MRI’s, Ultrasound or CT-scans.

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• Every new patient is assessed by one of our Specialist Podiatrists.
• We appreciate that every patient will require an individual, tailor-made management plan.
• We will never recommend procedures which we feel will not be effective or you do not need.

The foot is a complex structure of 28 different bones, 214 ligaments and 38 muscles, bearing our body weight as we walk every day and often challenging to treat. At your first appointment a detailed medical history will be undertaken by your Specialist prior to carrying out a brief physical examination of the presenting problem. This will allow for an accurate and professional diagnosis of the condition. Recommendations can then be made on further testing, treatments and management of the problem.

We believe in a multi-disciplinary approach to patient management and work tirelessly to ensure that our patients receive world-class health care. Should you require onward referral or input from other health professionals, your Specialist will be able to establish these links and work with colleagues closely on the management of your presenting issues to provide you with a holistic approach to your health management.

At your first appointment most routine Podiatry procedures can be undertaken there and then, however some conditions may require additional appointment, further imaging, testing and onward referral. Your Specialist will make you aware of the pathway during your consultation. Small procedures are often undertaken without additional fee as a courtesy to our patients, more invasive procedures may incur further costs and we advise referral to our Price Charter, should you have any doubts please feel free to contact us at info@s666316446.websitehome.co.uk or visit www.s666316446.websitehome.co.uk

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